Public health and urban planning have common roots in early 20th century efforts to improve urban living conditions. But despite these shared origins and the fact that California's Community Redevelopment Law is part of the state's Health and Safety Code, redevelopment agencies and public health advocates have just begun to collaborate.
"The lightbulb only recently went on," says Jim Kennedy, redevelopment director for the Contra Costa County Redevelopment Agency. "Redevelopment and public health have the same goals. Now we're aligning more clearly." This new partnership is rooted in the recognition that how cities are built has a profound impact on the health of the people who live in them.
Redevelopment agencies work in areas that have been designated as “blighted.” Many of the criteria for blight, including crime, poor-quality housing, and a lack of nearby sources of fresh and healthy food, are also conditions that make these low-income communities unhealthy places to live.
Bob Prentice, director of the Bay Area Regional Health Inequities Initiative, says this overlap makes redevelopment and public health advocates natural partners. "Redevelopment has a mandate to work in poor neighborhoods,” he says. “We in public health want to work in those neighborhoods because that's where we really see health inequities."
Redevelopment puts health first when it creates parks that give residents a place to exercise and interact with one another; improves housing quality; plans streets and transportation that encourage walking, biking, and the use of public transit; makes neighborhoods safer; reduces negative environmental impacts; and increases access to healthy food by supporting full-service grocery stores, farmers’ markets, and community gardens. All of these changes should benefit longtime residents, instead of displacing them, as redevelopment projects have often done in the past.
Redevelopment agencies can prioritize public health by making health considerations an explicit part of the planning process. The City of Richmond's planning department has done this in its general plan, and Contra Costa County's redevelopment agency is following suit in its specific plan for the unincorporated community of North Richmond.
Likewise, health advocates can promote projects like these by learning the ins and outs of planning and redevelopment, so they can ensure that public health is a central part of redevelopment plans and help build community support for healthy development efforts. Another way for health advocates to engage effectively is to use data that shows the impact of environmental factors on health. For example, the San Francisco Department of Public Health has developed an evidence-based online tool to measure how urban design and planning impact residents' health. The Healthy Development Measurement Tool assesses communities based on more than 100 variables, from transit accessibility and crime rates to housing density and energy consumption. Then the tool identifies healthy planning goals and recommends policies to help accomplish them.
Building healthier communities can still be a challenge. Because redevelopment agencies have limited budgets and must fund projects with revenues generated by their activities, some projects present a tradeoff. While a neighborhood park, for instance, brings clear health benefits, the financial incentive to build one is smaller than for erecting, say, a parking garage.
Furthermore, there is not currently a mandate for redevelopment to incorporate health concerns in planning. Bob Prentice and others would like to see that change. "Deep investments in this kind of community health infrastructure have profound consequences,” he says. “What redevelopment does is more constructive for public health than all the health fairs in the world."